Provider Demographics
NPI:1629466701
Name:CORNERSTONE ADULT CARE LLC
Entity Type:Organization
Organization Name:CORNERSTONE ADULT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-809-0591
Mailing Address - Street 1:2785 PACIFIC COAST HWY
Mailing Address - Street 2:107
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7066
Mailing Address - Country:US
Mailing Address - Phone:323-829-4536
Mailing Address - Fax:
Practice Address - Street 1:2785 PACIFIC COAST HWY
Practice Address - Street 2:107
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7066
Practice Address - Country:US
Practice Address - Phone:323-829-4536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-24
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home